Into Balance 02/2006
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CONTENT THEREInto IS ALWAYSBalance AN ALTERNATIVE SOLUTION • Comparison of the top 100 drugs in Slovakia and the Czech Republic YEAR I FEBRUARY 2006 • Individual health insur- ance and its position on Comparison of the top 100 drugs the market • The Free Forum platform: in Slovakia and the Czech Republic More State, No Market Methodology: panies in Slovakia, 58% in the Czech payments for the Standard Drug Dose (in The costs of health insurance companies Republic. The prices of 62% of the drugs the Czech Republic and Slovakia) then • Monitoring of the news spent on recipe drugs between July 1, were lower in Slovakia than the Czech the Slovak payment system would save (January 2006) 2004 and June 30, 2005 were used to Republic. Sk 1.4 billion per year (11.2% of the costs compile a list of the most costly groups of Even though the top 100 included a major- of insurance companies on the top 100 • The forecast is positive drugs. The groups of drugs are those ity of those drug groups which have a drug groups). If the same measure was used in the Health Ministry's classification taken by the Czech health insurance despite the political higher co-payment in Slovakia than in the and reflect the ATC group and delivery Czech Republic, nearly one half of these system and the consumption was similar insecurity method, drug form and the quantity of the groups was available at a lower price in to Slovakia, it would save Sk 1.2 billion active substance in one dose. The prices Slovakia (27 cases out of 58, i.e. 47%). per year. • Rath plans to increase and fees in Slovakia and the Czech Re- As many as 61 % drug groups with an Conclusion: health insurance contri- public are as of January 1, 2006. The SDD price (in Slovakia) lower than Sk 10 The prices and co-payments in these butions from 13.5% to lowest price for the standard drug dose had a lower co-payment in Slovakia too. groups of drugs are different in the two (SDD) according to the Ministry's classifi- 19.4% For drug groups with an SDD price above countries. The difference is caused, cation was calculated, net of the distribu- Sk 10 the proportion was only 25%. among other aspects, by a different ap- tor's and pharmacy's margins and VAT – For antibiotics which are almost never proach to the drugs policy by the classifi- elements which are different in the two cation committees at the Health Ministries countries. The same method was used to fully covered in Slovakia, contrary to the Czech Republic, both prices and co- of both countries. It cannot be determined obtain a net co-payment for the standard payments in Slovakia are much lower - in which system is more efficient, but both drug dose. All data was converted to SKK some cases by one half. can learn lessons from each other and using the NBS exchange rate as of Feb- contribute to a more efficient use of the ruary 13, 2006. Among drugs for which no generics exist on the market as many as 82% had a solidarity resources. If the more favorable Results: higher co-payment in Slovakia than the payments were hypothetically taken into The one hundred most costly drug Czech Republic (contrary to the drugs consideration then the Slovak and the groups attracted more than one half with generics where only 41% had a Czech public sectors would save Sk 1.4 (50.9%) of the costs spent by insurance higher co-payment in Slovakia than in the and 1.2 billion respectively. companies on drugs in Slovakia. Czech Republic). ANGELIKA SZALAYOVÁ 42 % of these drugs are more favorable If co-payments for individual groups are (the author is a member from the viewpoint of the insurance com- set at the lower of the current levels of of the Board of VšZP, a. s.) Table 1: The ten greatest differences in payments for ATC groups in Slovakia and the Czech Republic (first in favour of Slo- vakia and then in favour of the Czech Republic). The whole table of the top 100 ATC groups can be found at http://www.hpi.sk/attachments/top_100_atc.pdf Slovakia (no margins Czech Republic (no Price/SDD UZP/SDD Extended in SK vs. in SK vs. The rank ATC Group Name or VAT) margins or VAT) photo Information Price/SDD UZP/SDD Price/SDD UZP/SDD Price/SDD UZP/SDD in CS in CS on this page 3 C10AA01 Simvastatin p.o. do 20 mg 4,711 4,520 6,461 7,342 1,750 2,822 can be found on www.rock-on-rock-on.com. 13 R06AE07 Cetirizin p.o. 3,100 2,483 4,895 5,384 1,794 2,901 Bill Dan from California 37 M01AX25 Chondroitin sulphate p.o. 18,874 9,422 23,045 14,352 4,171 4,930 proves that finding 42 J01FA09 Claritromicine p.o. SR solid drug form 32,613 28,966 49,995 35,243 17,382 6,276 balance is a real art. 48 N06AB04 Citalopram p.o. 4,138 5,602 11,483 11,748 7,345 6,145 65 A02BC01 Omeprazol p.o. above 10 mg 3,204 3,056 8,174 8,174 4,971 5,119 Amoxicillin and ß- 68 J01CR02 p.o. 625 mg solid DF 18,063 14,451 25,570 25,570 7,507 11,119 lactamase inhibitor 75 N06AB05 Paroxetin p.o. 6,048 5,921 11,748 11,748 5,700 5,827 Into Balance 89 A02BA03 Famotidin p.o. 0,942 1,464 3,035 3,035 2,093 1,571 monthly newsletter 98 J01FA09 Claritromicin p.o. 500 mg solid DF 17,298 14,706 35,243 35,243 17,945 20,537 on health policy Slovakia (no margins Czech Republic (no Price/SDD UZP/SDD Extended in SK vs. in SK vs. rank ATC Group Name or VAT) margins or VAT) Information Price/SDD UZP/SDD Price/SDD UZP/SDD Price/SDD UZP/SDD HPI - Health Policy Institute in CZ in CZ Formoterol and other inhal. with budeson- 10 R03AK07 39,167 37,815 42,218 16,183 3,051 -21,632 Hviezdoslavovo nám. 17 antiasthmatics ide plv.inh 811 02 Bratislava 11 M05BA04 Alendronic acid p.o. above 10 mg 33,422 33,104 18,600 20,558 -14,822 -12,546 Slovak Republic 15 M05BA07 Risedronic acid p.o. 35 mg tbl.flm. 37,722 35,969 53,118 20,558 15,396 -15,411 22 A16AX01 Thioctic acid p.o. 7,810 7,703 8,419 0,000 0,609 -7,703 43 N03AX09 Lamotrigin p.o. 100 mg 55,004 72,702 46,011 46,011 -8,993 -26,691 Phone: +421 2 54 643 051 49 M05BA08 Zoledronic acid parent pulv inf 1x5ml 10 408,709 10 408,709 13 606,091 7 978,516 3 197,382 -2 430,193 E-mail: [email protected] 51 N06AB10 Escitalopram p.o. 26,413 24,764 12,795 11,748 -13,618 -13,017 85 N04BC04 Ropinirole p.o. tbl. 99,003 97,848 76,046 61,841 -22,958 -36,007 88 C02CA06 Urapidil p.o. 18,289 14,388 11,562 6,735 -6,727 -7,652 94 R06AX27 Desloratadin p.o. solid LF tbl.flm. 11,999 10,059 14,352 5,384 2,353 -4,674 Source: Slovak Health Ministry data and information from the Czech VZP (insurance company), calculations by the author, 2006 YEAR I PAGE 2 January 2006: Všeobecná zdravotná poisťovňa begins issuing 'drug Individual health insurance books'. It hopes that the books will ensure efficient use of drugs at ade- quate doses so that the life and health of patients are not placed and its position on the market under threat by a combination of several drugs. January 2: Ministry of Finance an- Act No. 580/2004 on Health Insur- 1. Insurance of insured event – The position of individual health nounces that by the end of February ance which entered into force on accident, illness insurance in Slovakia is very weak 2006 it should produce a pros-and- January 1, 2005 defined two types 2. Health care insurance and the products offered by com- cons analysis of the joint collection of health insurance: mercial insurance providers attest of taxes and contributions. • more frequent preventive to this fact. Out of the 25 insurers 1. public health insurance is an checks January 2: A rescue helicopter on its insurance policy which gives • some medical aids, e.g. operating on the Slovak market way to Žilina to pick up a cardiac every citizen the right to medi- contact lenses, glasses, only one offers it as a separate patient crashed near Jánova Lehota cal care and services related dental prosthetics etc. product (Union, a.s.) and its share in the district of Žiar nad Hronom. in the Slovak market of non-life None of the three members of the to health care to the extent • securing a date of treat- crew survived. specified by Act 576/2004 on ment by a specialist practi- insurance is lower than 0.2%. Health Care and Act 577/2004 tioner January 4: A prosecutor of the Spe- on the Extent of Health Care • premium hospital care This product is also partially of- cial Prosecutor's Office raised insurance (selected pro- fered by Generali, a.s. and charges against the former head 2. individual health insurance Uniqua, a.s. (which only offer acci- physician of the orthopedics depart- vider, selected surgeon, whose extent of medical care dent insurance and insurance of a ment in Trenčín Pavol P., accusing is defined in the insurance premium ward, added daily allowance during hospitaliza- him of accepting a bribe or another policy concluded voluntarily comfort, premium material, tion and sickness leave.